<%--
  Created by IntelliJ IDEA.
  User: houxianghua
  Date: 2015/10/12
  Time: 16:00
  To change this template use File | Settings | File Templates.
--%>
<%@ page contentType="text/html;charset=UTF-8" language="java" %>
<%@ include file="/WEB-INF/jsp/component/common.jsp" %>
<!DOCTYPE html>
<html lang="zh-CN">
<head>
  <meta charset="utf-8">
  <meta http-equiv="X-UA-Compatible" content="IE=edge">
  <meta name="viewport" content="width=device-width, initial-scale=1">
  <meta name="description" content="">
  <meta name="author" content="">
  <title>随访主页面</title>
  <%@include file="/WEB-INF/jsp/component/commonHead.jsp" %>
  <%@include file="/WEB-INF/jsp/component/commonBottom.jsp" %>
  <%--<script type="text/javascript" src="${assets}/PIE_IE678.js"></script>--%>
  <link rel="stylesheet" href="${assets}/followUp/hypertension/css/highblood.css" type="text/css">
  <link href="${css}/bootstrap-datetimepicker.min.css" rel="stylesheet"/>
  <script type="text/javascript" src="${assets}/followUp/hypertension/js/highblood.js"></script>
  <script type="text/javascript" src="${assets}/followUp/hypertension/js/dell.js" charset="UTF-8"></script>

  <script src="${js}/jquery.twbsPagination.min.js"></script>
  <script src="${js}/bootstrap-dateTime/bootstrap-datetimepicker.js"></script>
  <script type="text/javascript" src="${js}/bootstrap-dateTime/locales/bootstrap-datetimepicker.zh-CN.js" ></script>
</head>
<body>
<div class="visitData">
  <!-- 个人信息 -->
  <div class="information">
    <p class="personalTitle">个人信息</p>
    <div class="detail-top">
      <label>责任医师:</label>
      <div class="doctor">
        <input type="text">
      </div>
      <div class="form-group">
        <label>随访时间:</label>
        <div id="Time" class="input-group date form_date col-md-5" style="width: 146px"  data-date-format="yyyy-mm-dd">
          <input class="form-control" size="12" type="text" value="2015-07-24" readonly style="text-indent:0">
                  	<span class="input-group-addon">
                  		<span class="glyphicon glyphicon-calendar aria-hidden='true'"></span>
          </span>
        </div>
      </div>
    </div>
    <div class="detail-bottom drop-down">
      <div class="visit-type">
        <label>随访方式:</label>
        <div class="select">
          <div class="base" id="VisitType" data-value="2"></div>
          <span></span>
          <ul class="test">
            <li data-option-value="1">不详</li>
            <li data-option-value="2">家庭随访</li>
          </ul>
        </div>
      </div>
      <div class="HighBloodType">
        <label class="blank">高血压类型:</label>
        <div class="select">
          <div class="base" id="BloodType" data-value="1"></div>
          <span></span>
          <ul class="test">
            <li data-option-value="1">原发</li>
            <li data-option-value="2">并发感染</li>
          </ul>
        </div>
      </div>
    </div>
  </div>
  <!-- 症状 -->
  <div class="symptom">
    <div class="symptomTitle">
      症状
    </div>
    <div class="symptomDetail">
      <div class="no">
        <input type="checkbox" id="NoSymptom">
        <label for="NoSymptom">无症状</label>
      </div>
      <div class="have">
        <input type="checkbox" id="headSymptom">
        <label for="headSymptom">头痛头晕</label>
        <input type="checkbox" id="vomiting">
        <label for="vomiting">恶心呕吐</label>
        <input type="checkbox" id="tinnitus">
        <label for="tinnitus">眼花耳鸣</label>
        <input type="checkbox" id="DifficultyBreath">
        <label for="DifficultyBreath">呼吸困难</label>
        <input type="checkbox" id="Palpitations">
        <label for="Palpitations">心悸胸闷</label>
        <input type="checkbox" id="numb">
        <label for="numb">四肢麻木</label>
      </div>
      <div class="other">
        <input type="checkbox" id="EpistaxisBleed">
        <label for="EpistaxisBleed">鼻衄出血</label>
        <input type="checkbox" id="edema">
        <label for="edema">下肢水肿</label>
        <input type="checkbox" id="otherDisease">
        <label for="otherDisease" class="last">其他</label>
        <input type="text" value="其他" class="otherText" />
      </div>
    </div>
  </div>
  <!-- 体征 -->
  <div class="signs">
    <div class="signsTitle">
      体征
    </div>
    <div class="signsDetail">
      <div class="signs_left">
        <div class="BloodPressure">
          <label>血压(mmHg):</label>
          <input type="text">&nbsp;&nbsp;/&nbsp;&nbsp;<input type="text">
        </div>
        <div class="weight">
          <label>体重(kg):</label>
          <input type="text">&nbsp;&nbsp;/&nbsp;&nbsp;<input type="text">
        </div>
        <div class="bmi">
          <label>体质指数:</label>
          <input type="text">&nbsp;&nbsp;/&nbsp;&nbsp;<input type="text">
        </div>
      </div>
      <div class="signs_right">
        <div class="Heartrate">
          <label>心率(次/分):</label>
          <input type="text">
        </div>
        <div class="height">
          <label>身高:</label>
          <input type="text">
        </div>
        <div class="other">
          <label>其他:</label>
          <input type="text">
        </div>
      </div>
    </div>
  </div>
  <!-- 生活指导方式 -->
  <div class="guideWay">
    <div class="guideWayTitle">
      生活指导方式
    </div>
    <div class="guideWayDetail">
      <div class="guideWayDetail_t">
        <div class="smoke">
          <label>日吸烟量(支):</label>
          <input type="text">&nbsp;&nbsp;/&nbsp;&nbsp;<input type="text">
        </div>
        <div class="drink">
          <label>日饮酒量(两):</label>
          <input type="text">&nbsp;&nbsp;/&nbsp;&nbsp;<input type="text">
        </div>
      </div>
      <div class="guideWayDetail_c">
        <div class="sport">
          <label>运动量:</label>
          <input type="text">
          <span class="week">&nbsp;次、周&nbsp;</span>
          <input type="text">
          <span>&nbsp;&nbsp;分/次</span>
        </div>
      </div>
      <div class="guideWayDetail_bc drop-down">
        <div class="saltSituation">
          <label>摄盐情况(咸淡):</label>
          <div class="select">
            <div class="base" id="salt" data-value="2"></div>
            <span></span>
            <ul class="test">
              <li data-option-value="1">轻</li>
              <li data-option-value="2">重</li>
            </ul>
          </div>
        </div>
      </div>
      <div class="guideWayDetail_b drop-down">
        <div class="adjustment">
          <label>心理调整:</label>
          <div class="select">
            <div class="base" id="phychologist" data-value="2"></div>
            <span></span>
            <ul class="test">
              <li data-option-value="1">良好</li>
              <li data-option-value="2">一般</li>
            </ul>
          </div>
        </div>
        <div class="behavoir">
          <label>嘱医行为:</label>
          <div class="select">
            <div class="base" id="doctorBehavior" data-value="2"></div>
            <span></span>
            <ul class="test">
              <li data-option-value="1">良好</li>
              <li data-option-value="2">一般</li>
            </ul>
          </div>
        </div>
      </div>

    </div>
  </div>
  <!-- 辅助检查 -->
  <div class="AuxiliaryCheck">
    <div class="checkHead">
      <div class="CheckTitle">
        辅助检查
      </div>
      <div class="Add">
        <input type="button" value="新增">
      </div>
    </div>
    <table id="Check">
      <thead>
      <tr>
        <th>辅助检查项目</th>
        <th>辅助检查结果</th>
        <th>检查人</th>
        <th>检查日期</th>
        <th>操作</th>
      </tr>
      </thead>
      <tbody>
      <tr>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
      </tr>
      <tr>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
      </tr>
      <tr>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
      </tr>
      <tr>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
      </tr>
      <tr>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
      </tr>
      </tbody>
    </table>

  </div>
  <!-- 服药依从性 -->
  <div class="takeMedicine">
    <div class="takeMedicineTitle">
      服药依从性
    </div>
    <div class="Medicine drop-down">
      <div class="Adherence">
        <label>服药依从性:</label>
        <div class="select">
          <div class="base" id="MedicationAdhere" data-value="2"></div>
          <span></span>
          <ul class="test">
            <li data-option-value="1">规律</li>
            <li data-option-value="2">不规律</li>
          </ul>
        </div>
      </div>
    </div>
  </div>
  <!-- 药物不良反应 -->
  <div class="AdverseReactions">
    <div class="ReactionsTitle">
      不良反应
    </div>
    <div class="survey">
      <input type="radio" id="have" name="BadReactions"><label for="have">有</label>
      <input type="radio" id="no" name="BadReactions"><label for="no">无</label>
      <input type="text" class="oTxt">
    </div>
  </div>
  <!-- 此次随访分类 -->
  <div class="classification">
    <div class="classificationTitle">
      此次随访分类:
    </div>
    <div class="visitClassification drop-down">
      <label>此次随访分类:</label>
      <div class="select">
        <div class="base" id="VisitClass" data-value="2"></div>
        <span></span>
        <ul class="test">
          <li data-option-value="1">控制良好</li>
          <li data-option-value="2">控制不好</li>
        </ul>
      </div>
    </div>
  </div>
  <!-- 用药情况 -->
  <div class="drugSituation ">
    <div class="drugHead">
      <div class="drugTitle">
        用药情况:
      </div>
      <div class="drugBtn">
        <input type="button" value="新增">
      </div>
    </div>
    <table id="drugTable">
      <thead>
      <tr>
        <th>序号</th>
        <th>药物名称</th>
        <th>药物类型</th>
        <th>用量</th>
        <th>药物单位</th>
        <th>用法</th>
        <th>使用总剂量</th>
        <th>给药方式</th>
        <th>操作</th>
      </tr>
      </thead>
      <tbody>
      <tr>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
      </tr>
      <tr>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
      </tr>
      <tr>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
      </tr>
      <tr>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
      </tr>
      <tr>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
        <td></td>
      </tr>
      </tbody>
    </table>
  </div>
  <!-- 治疗建议 -->
  <div class="suggestion">
    <div class="suggestTitle">
      治疗建议:
    </div>
    <div class="TreatmentSuggest">
      <label>治疗建议:</label>
      <input type="text" class="treatment">
    </div>
  </div>
  <!-- 转诊 -->
  <div class="referral">
    <div class="referralTitle">
      转诊:
    </div>
    <div class="referralDetail">
      <span class="title">转诊:</span>
      <div class="referralForm">
        <input type="radio" name ="referral" id="referralNo">
        <label for="referralNo">无</label>
        <input type="radio" name ="referral" id="referralHave">
        <label for="referralHave">有</label>
      </div>
      <div class="referralText">
        <label>原因:</label>
        <input type="text">
        <label>机构及科室:</label>
        <input type="text">
      </div>
    </div>
  </div>
  <!-- 转诊回访 -->
  <div class="returnVisit">
    <div class="returnVisitTitle">
      转诊回访:
    </div>
    <div class="returnVisitDetail">
      <div class="form-group">
        <label id="DATE">日期:</label>
        <div id="VisitTime" class="input-group date form_date col-md-5" style="width: 146px"  data-date-format="yyyy-mm-dd">
          <input class="form-control" size="12" type="text" value="2015-07-24" readonly style="text-indent:0">
                  	<span class="input-group-addon">
                  		<span class="glyphicon glyphicon-calendar aria-hidden='true'"></span>
          </span>
        </div>
      </div>
      <div class="diseaseCheckbox">
        <div class="organTitle">
          <p>靶器官损害:</p>
          <p>合并症:</p>
        </div>
        <div class="organ1">
          <input type="checkbox" id="heart">
          <label for="heart">心脏</label>
          <input type="checkbox" id="hypertrophy">
          <label for="hypertrophy">左室肥厚</label>
          <input type="checkbox" id="retinopathy">
          <label for="retinopathy">视网膜病变</label>
        </div>
        <div class="organ2">
          <input type="checkbox" id="brain">
          <label for="brain" class="theBrain">脑</label>
          <input type="checkbox" id="HeartFailure">
          <label for="HeartFailure" class="theHeartFailure">心力衰竭</label>
          <input type="checkbox" id="atherosis">
          <label for="atherosis" class="theAtherosis">动脉粥样硬化</label>
        </div>
        <div class="organ3">
          <input type="checkbox" id="kidney">
          <label for="kidney">肾脏</label>
          <input type="checkbox" id="Coronary">
          <label for="Coronary">冠心病</label>
          <input type="checkbox" id="otherorgan">
          <label for="otherorgan">其他</label>
        </div>
        <div class="organ4">
          <input type="checkbox" id="vascular">
          <label for="vascular">周围血管</label>
          <input type="checkbox" id="Arrhythmia">
          <label for="Arrhythmia">心律失常</label>
        </div>
        <div class="organ5">
          <input type="checkbox" id="fundus">
          <label for="fundus">眼底</label>
          <input type="checkbox" id="stroke">
          <label for="stroke">脑卒中</label>
        </div>
        <div class="organ6">
          <input type="checkbox" id="otherDisease2">
          <label for="otherDisease2">其他</label>
          <input type="checkbox" id="aorta">
          <label for="aorta" class="theAorta">主动脉夹层动脉瘤</label>
        </div>
      </div>
      <div class="OtherIllnesses">
        <label>其他疾病:</label>
        <input type="text">
      </div>
      <div class="last">
        <div class="form-group">
          <label>下次随访日期:</label>
          <div id="NextTime" class="input-group date form_date" style="width: 120px"  data-date-format="yyyy-mm-dd">
            <input class="form-control" size="12" type="text" value="2015-07-24" readonly style="text-indent:0">
	                  	<span class="input-group-addon">
	                  		<span class="glyphicon glyphicon-calendar aria-hidden='true'"></span>
            </span>
          </div>
        </div>
        <div class="doctorName">
          <label>随访医生签名:</label>
          <input type="text">
        </div>
      </div>
    </div>
  </div>
</div>

<script type="text/javascript">
  $(document).ready(function(){
    $('.date').datetimepicker({
      language:  'zh-CN',
      weekStart:  0,
      todayBtn: true,
      autoclose:  1,
      todayHighlight: 1,
      startView: 2,
      minView: 2,
      forceParse: 0,
      format: "yyyy-mm-dd"
    });

  });

</script>


</body>
</html>
